Healthcare Provider Details

I. General information

NPI: 1669335097
Provider Name (Legal Business Name): LAURA JESSICA ROBERTS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5009 FRANKFORD AVE
BALTIMORE MD
21206-5353
US

IV. Provider business mailing address

248 WEST ST
BATH PA
18014-1027
US

V. Phone/Fax

Practice location:
  • Phone: 410-325-4000
  • Fax:
Mailing address:
  • Phone: 484-721-8358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: